Clinical Procedures Skills Course application

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Clinical Procedures Skills Course application
Clinical Procedures Skills Course
(Ultrasound Assisted)
Suited to Trainees and Acute Care Specialists
Parallel Practical Sessions on:
Central Venous Catheterisation, Chest Drain, Paracentesis of Abdomen, Knee Joint
Aspiration, Lumbar Puncture, Non Invasive Ventilation (NIV)
Incorporating: Principles of Ultrasound, Sterile Workplace, Local Anaesthesia
Monday 21 July 2014
Education & Training Centre, James Paget Hospital
Organisers:
Dr Josip Stosic, Consultant ICU/Acute Medicine, JPUH
Application Form
Surname:…………………………………....... First Name:……………………………………...
Specialty/Grade:……………………………………………………………………………………
Hospital Address:…………………………………………………………………………………..
…………………………………………………………………………………………………….....
Telephone Mobile:……………………………………………………………………………….
Hospital:……………………………................Home:………………………………………….....
Email:…………………………………………………………………………………………………
Dietary requirements: (Please Specify)…………………………………………………………..
Cost: £110.00
Please return this form with your payment made payable to:
“James Paget University Hospitals NHS Foundation Trust” and forward to:
Daniel Smith, Education Administrator, PGME Dept. James Paget University Hospital,
Lowestoft Road, Gorleston, Great Yarmouth, NR31 6LA
Or Direct BACS payment to:
Account Name:
JPUH NHS Foundation Trust
Sort Code:
08-33-00
Please quote ref number: CPSJUN14
Account Number:
Bank name:
12509393
Citi Bank
For further details, contact:
Daniel Smith, email: [email protected], Tel: 01492 452417 Fax: 01493 452182

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